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Section
Hepatic and Biliary Disorders
Hepatic and Biliary Disorders
Alcoholic Liver Disease
Alcoholic Liver Disease
Risk Factors
Quantity of alcohol
Sex
Genetic factors
Nutritional status
Other factors
Pathophysiology
Alcohol absorption and metabolism
Hepatic fat accumulation
Endotoxins in the gut
Oxidative damage
Resultant inflammation, cell death and fibrosis
Pathology
Symptoms and Signs
Diagnosis
Prognosis
Treatment
Restricting alcohol intake
Supportive care
Specific treatment
Approach to the Patient with Liver Disease
Introduction
Pathophysiology
Evaluation
History
Physical examination
Ascites
Etiology
Pathophysiology
Symptoms and Signs
Diagnosis
Treatment
Spontaneous Bacterial Peritonitis (SBP)
Symptoms and Signs
Diagnosis
Treatment
Fatty Liver
Nonalcoholic Steatohepatitis (NASH)
Pathophysiology
Symptoms and Signs
Diagnosis
Prognosis
Treatment
Inborn Metabolic Disorders Causing Hyperbilirubinemia
Gilbert Syndrome
Crigler-Najjar Syndrome
Primary Shunt Hyperbilirubinemia
Dubin-Johnson Syndrome and Rotor's Syndrome
Dubin-Johnson syndrome
Rotor's syndrome
Jaundice
Pathophysiology
Mechanisms of hyperbilirubinemia
Consequences
Etiology
Evaluation
History
Physical examination
Red flags
Interpretation of findings
Testing
Treatment
Geriatrics Essentials
Key Points
Portal Hypertension
Etiology
Pathophysiology
Symptoms and Signs
Diagnosis
Prognosis
Treatment
Portal–Systemic Encephalopathy
Etiology
Precipitants
Pathophysiology
Symptoms and Signs
Diagnosis
Prognosis
Treatment
Postoperative Liver Dysfunction
Postoperative jaundice
Postoperative hepatitis
Postoperative cholestasis
Systemic Abnormalities in Liver Disease
Circulatory Abnormalities
Endocrine Abnormalities
Hematologic Abnormalities
Renal and Electrolyte Abnormalities
Hepatorenal syndrome
The Asymptomatic Patient With Abnormal Laboratory Test Results
Aminotransferases
Alkaline phosphatase
Drugs and the Liver
Introduction
Effects of Liver Disease on Drug Metabolism
Liver Injury Caused by Drugs
Pathophysiology
Patterns of liver injury
Diagnosis
Treatment
Prevention
Fibrosis and Cirrhosis
Introduction
Cirrhosis
Pathophysiology
Complications
Histopathology
Symptoms and Signs
Diagnosis
General approach
Laboratory tests
Diagnostic imaging
Identification of the cause
Liver biopsy
Monitoring
Prognosis
Treatment
Primary Biliary Cirrhosis (PBC)
Etiology
Symptoms and Signs
Diagnosis
Prognosis
Treatment
Fibrosis
Pathophysiology
Symptoms and Signs
Diagnosis
Treatment
Gallbladder and Bile Duct Disorders
Introduction
Acalculous Biliary Pain
Diagnosis
Treatment
Postcholecystectomy Syndrome
Diagnosis
Treatment
AIDS Cholangiopathy
Diagnosis
Treatment
Cholecystitis
Acute Cholecystitis
Acute acalculous cholecystitis
Symptoms and Signs
Complications
Acute acalculous cholecystitis
Diagnosis
Acute acalculous cholecystitis
Treatment
Chronic Cholecystitis
Symptoms and Signs
Diagnosis
Treatment
Choledocholithiasis and Cholangitis
Diagnosis
Treatment
Cholelithiasis
Pathophysiology
Symptoms and Signs
Diagnosis
Prognosis
Treatment
Surgery
Stone dissolution
Sclerosing Cholangitis
Primary Sclerosing Cholangitis (PSC)
Etiology
Symptoms and Signs
Diagnosis
Treatment
Tumors of the Gallbladder and Bile Ducts
Symptoms and Signs
Diagnosis
Treatment
Hepatitis
Introduction
Acute Viral Hepatitis
Etiology
Hepatitis A virus (HAV)
Hepatitis B virus (HBV)
Hepatitis C virus (HCV)
Hepatitis D virus (HDV)
Hepatitis E virus (HEV)
Symptoms and Signs
General
Virus-specific
Diagnosis
Initial diagnosis
Serology
Biopsy
Treatment
Prevention
HAV
HBV
HDV, HCV, and HEV
Fulminant Hepatitis
Chronic Hepatitis
Etiology
Symptoms and Signs
Diagnosis
Prognosis
Treatment
Autoimmune hepatitis
HBV
HCV
Liver Masses and Granulomas
Introduction
Benign Liver Tumors
Hepatocellular adenoma
Focal nodular hyperplasia
Hemangiomas
Other benign tumors
Hepatic Cysts
Hepatic Granulomas
Etiology
Pathophysiology
Symptoms and Signs
Diagnosis
Prognosis
Treatment
Metastatic Liver Cancer
Symptoms and Signs
Diagnosis
Treatment
Hematologic Cancers and the Liver
Primary Liver Cancer
Hepatocellular Carcinoma
Etiology
Symptoms and Signs
Diagnosis
Staging
Screening
Treatment
Prevention
Other Primary Liver Cancers
Fibrolamellar carcinoma
Cholangiocarcinoma
Hepatoblastoma
Angiosarcoma
Testing for Hepatic and Biliary Disorders
Introduction
Imaging Tests
Ultrasonography
Doppler ultrasonography
CT
Cholescintigraphy
Radionuclide liver scanning
Plain x-ray of the abdomen
MRI
ERCP
Percutaneous transhepatic cholangiography (PTC)
Operative cholangiography
Laboratory Tests
Tests for Liver Injury
Aminotransferases
Lactate dehydrogenase
Tests for Cholestasis
Bilirubin
Alkaline phosphatase
5′-Nucleotidase
γ‑Glutamyl transpeptidase (GGT)
Tests of Hepatic Synthetic Capacity
PT and INR
Serum proteins
Other Laboratory Tests
Ammonia
Serum immunoglobulins
Antimitochondrial antibodies
Other antibodies
α‑Fetoprotein (AFP)
Liver Biopsy
Indications
Contraindications
Other routes
Vascular Disorders of the Liver
Introduction
Congestive Hepatopathy
Diagnosis
Treatment
Hepatic Artery Disorders
Hepatic Artery Occlusion
Diagnosis
Treatment
Aneurysms
Hepatic Ischemia
Ischemic Hepatitis
Diagnosis
Treatment
Ischemic Cholangiopathy
Hepatic Vein Disorders
Budd-Chiari Syndrome
Etiology
Symptoms and Signs
Diagnosis
Prognosis
Treatment
Veno-occlusive Disease
Diagnosis
Treatment
Peliosis Hepatis
Portal Vein Disorders
Portal Vein Thrombosis
Etiology
Symptoms and Signs
Diagnosis
Treatment
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